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BDS4 Oral Medicine > Pathology 3 - Salivary tumours > Flashcards

Pathology 3 - Salivary tumours Flashcards

1
Q

What are causes for change in salivary gland size?

A
  • secretion retention (mucocele or duct obstruction)
  • chronic sialadenitis
  • gland hyperplasia (sialosis, sjogrens)
  • neoplasm
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2
Q

What are causes of chronic sialadenitis?

A
  • bacterial from xerostomia
  • viral
  • more common in parotid
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3
Q

What are signs of salivary tumour?

A
  • localised swelling
  • neurological change in facial nerve
  • painless
  • slow growing
  • well defined
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4
Q

Describe the epidemiology of salivary tumours.

A
  • uncommon
  • 3% of head and neck neoplasms
  • 75% are benign
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5
Q

What is the most common gland for salivary tumours?

A

Parotid - only 15% malignant

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6
Q

What is the most common gland for malignant salivary tumours?

A

Sublingual - 0.5% of tumours overall, 80% of these malignant

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7
Q

What is the general rule for salivary gland malignancy?

A

The smaller the gland the more likely to be malignant

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8
Q

What are the different histological typing of tumours?

A

Epithelial
- benign or adenoma
- malignant or adenocarcinoma
Non-epithelial
- lymphoma
- sarcoma

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9
Q

What are the clinal features of a major salivary gland tumour?

A
  • lump in gland
  • asymmetry
  • obstruction
  • pain or facial palsy (late sign for parotid)
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10
Q

What are the clinal features of a minor salivary gland tumour?

A
  • often found at junction of hard/soft palate
  • upper lip or cheek
  • ulcerate (late sign of malignancy)
  • can be ectopic in tongue
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11
Q

What are the different biopsy types suitable for salivary gland tumours?

A
  • FNA
  • core biopsy
  • incisional biopsy
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12
Q

What does NOS indicate?

A

Cancer that is not otherwise specified (does not fit any category)

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13
Q

What are the features of pleomorphic adenoma?

A
  • 75% of salivary tumours, most common in parotid
  • slow growth, painless
  • varied histopathology, capsule is variable (benign tumours usually incomplete capsule)
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14
Q

What cells are common to see in pleomorphic adenoma?

A
  • duct epithelium
  • myoepithelium cells
  • myxoid and chondroid areas
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15
Q

What is the treatment of pleomorphic adenoma?

A

Wide local excision

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16
Q

What problems are associated with pleomorphic adenoma?

A
  • recurrence is common due to multifocal presentation
  • progression to carcinoma 5%
17
Q

What are the features of adenolymphoma?

A
  • aka warthin’s tumour
  • related to smoking
  • 15% of salivary tumours, most common in parotid
  • occasionally bilateral or multifocal
  • recurrence is low, malignant change low
18
Q

What is the histology of adenolymphoma?

A
  • cystic
  • distinctive epithelium
  • lymphoid tissue
19
Q

What is the treatment of adenolymphoma?

A

Excision

20
Q

What are the features of adenoid cystic carcinoma?

A
  • 5% of tumours, more common in minor glands
  • local spread is common to nerves and bone
  • perineural pain presents with dull continuous pain
  • varied histology
21
Q

What histological patterns are seen in adenoid cystic carcinoma?

A
  • cribriform
  • tubular
  • solid
22
Q

What problems are associated with adenoid cystic carcinoma?

A
  • difficult to treat
  • recurrence high
  • prognosis poor at 20 years
  • late spread to lungs via metastasis in blood
23
Q

What are the common features of mucoepidermoid carcinoma?

A
  • 3-5% of tumours
  • cystic or solid
  • unpredictable
  • lymphatic spread rare
  • can be intraosseous (ectopic or odontogenic epithelium has multiple transformation potential)
24
Q

What cells are common to see in mucoepidermoid carcinoma?

A
  • squamous (epidermoid)
  • glandular (mucous)
25
Q

What stain is used to visualise mucous cells?

A

Alcian blue

26
Q

What are other salivary carcinomas of note?

A
  • acinic cell carcinoma (rare, parotid, varied histology)
  • polymorphous adenocarcinoma (minor palatal glands, perineural spread)

BDS4 Oral Medicine (31 decks)

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